Predictive performance of a target controlled infusion of Aquafol(TM) by use of a PION TCI(R) pump

ABSTRACT

BACKGROUND: The performance of a target controlled infusion (TCI) system needs to be confirmed in a clinical setting. Aquafol(TM), a microemulsion propofol, can be used for TCI with its pharmacokinetic parameters. The aim of this study is to evaluate the predictive performance of Aquafol(TM) TCI by using a PION TCI(R) pump incorporating the previously established pharmacokinetic parameters and ke0. METHODS: Thirty adult patients were enrolled in the study. General anesthesia was maintained with TCI of Aquafol(TM) and remifentanil using a PION TCI(R) pump. During the maintenance of anesthesia with a constant target effect-site concentration of propofol for at least for 20 minutes, blood was drawn and the propofol plasma concentration was measured. The predictive performance of Aquafol(TM) TCI was evaluated by determining the median performance error (MDPE), median absolute performance error (MDAPE), divergence, and wobble from the intra-individual and pooled performance errors. The acceptability of the TCI system was determined based on the pooled predictive performance. RESULTS: A total of 153 propofol blood samples were analyzed. The estimates of pooled MDPE, MDAPE, divergence and wobble were 8.59% (1.61), 19.1% (1.12), -1.12%/h and 9.87% (1.01), respectively. The MDAPE indicating the accuracy of the TCI infusion system was within the clinically acceptable range (< 20-30%) and the bias (MDPE) was also acceptable (< 10-20%). CONCLUSIONS: The performance of Aquafol(TM) TCI using a PION TCI(R) pump was acceptable for the clinical use.